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Peanut allergy successfully kept at bay with immune-based therapy (lactobacillus rhamnosus)

Posted on15 Jan 2020
This new therapy helped children allergic to peanuts eat these nuts with no reactions for up to four years. The study appeared this week in the journal Lancet Child & Adolescent Health. An earlier study had included children who were being treated with an immune based therapy that included probiotics along with minute doses of peanuts. These small peanut doses were supposed to treat the children by training up their immune system.

The immune system is the natural protection we have against foreign infections or proteins. In persons with allergies, these soldiers work overtime and their overwhelming response leads to the severe allergic reactions to peanuts or other allergens which may even be fatal. With repeated small doses of the peanuts given to these children, their immune systems started to recognize peanuts as familiar and did not treat it as foreign anymore. The latest therapy was termed probiotic and peanut oral immunotherapy (PPOIT).

The earlier study had shown the effectiveness of this combination therapy for a short duration. This latest study result was a follow up of those same children over a period of four years. The initial study had 56 eligible participants of which 48 were included in this new study.

The probiotic used was Lactobacillus rhamnosus and peanut protein was used in combination.

Treatment with the combination therapy was for 18 months in the initial study. There have been studies that have explored the fact that when an allergen – allergy causing substance – is given in small doses, the allergic response to it gradually comes down.

This is one of the ways allergies can be treated. This team of researchers went a step ahead by adding probiotics to the treatment. Probiotics help increase the ability of the gut to accept the peanuts and not start off an immune reaction. Probiotics are a mix of healthy bacteria that can colonize the gut and enhance immunity. According to lead researcher Prof Mimi Tang, an immunologist and allergist, the children who had participated in the earlier trial were eating peanut freely in their diet “years after treatment was completed”.

The children who had participated in the earlier study were invited to join in the new study. The treatment with the combination oral immune therapy was already over in the initial study. They were checked for various responses – allergic reaction to peanuts 4 years after treatment cessation, skin prick tests with peanut ingredients to see if an immune reaction is triggered, measurement of peanut sIgE and sIgG4 concentrations in blood that mark allergic tendencies to peanuts. Results from this study showed that when compared to the 4% children who did not get any treatment, 82% who were treated with the combination of peanut doses and probiotics had a significant reduction in their allergic reactions to peanuts.

For the four years of follow up too, 67% of those who got the combination therapy could eat peanuts safely without reaction compared to 4% of those who did not get the treatment. Skin prick tests with peanut allergen also led to smaller reaction in the treated children compared to those who did not get the treatment. Despite the fact that the results are promising, this therapy is far from being cited as cure for peanut allergy say experts.

It might take longer and more extensive studies to use this combination therapy as standard treatment for peanut allergy in kids.

The study was funded by the Murdoch Childrens Research Institute and Australian Food Allergy Foundation.
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